Tratamiento quirúrgico de los aneurismas del seno de Valsalva

Abstract

BackgroundIn this study, we reviewed our experience of 10years in the repair of the aneurysm of the sinus of Valsalva that are intact or broken and its long-term follow-up. MethodsA retrospective, cross-sectional review of 23 patients (13 men, 10 women, mean age 31years, range 21-61years) who underwent surgery for repair of Valsalva sinus aneurysm between January 2007 and February 2017. The aneurysm of the Valsalva originated from the right coronary sinus in 19 patients (82%), the left coronary sinus in 3 patients (10%), and the non-coronary sinus in 2 patients (8%). In 2 patients, the Valsalva sinus aneurysm was intact and in 21 (91%) it was ruptured, the most frequent occurrence was right ventricular rupture in 16 (69%), whereas right atrial rupture was present in 4 (17%), left ventricle in one (4.3%) and left atrium in one (4.3%). The common defects associated were aortic insufficiency in 12 patients (52%), ventricular septal defect in 9 (39%), tricuspid insufficiency in 3 (13%), atrial septal defect and patent ductus arteriosus (4.3%). Two repair techniques were used; in 17 (74%) a patch was used to close the defect and in 6 (26%) it was excluded with square points reinforced with Teflon. ResultsWe did not have hospital mortality. Follow-up, ranging from one month to 10years, was available in 100% of survivors. One patient presented leakage through the repair technique without hemodynamic repercussion. The actual survival rate was 95.7%. The freedom of reoperation was 100%. ConclusionSurgical repair is the optimal choice for the treatment of Valsalva sinus aneurysm. Early surgical intervention after diagnosis may improve the long-term prognosis of these patients.